| NPI | 1871572990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA DO-03258) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 03258) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2022-05-03 |